What's the best over-the-counter painkiller?

Dr Mark's reply...

The ideal choice varies with the individual and the cause and type of their pain.

As a general rule, ibuprofen works best, but has more side effects and interactions with other medicines such as aspirin, antidepressants and anticoagulants, so isn’t suitable for everyone.

Paracetamol is probably the safest option (unless taken in overdose) but isn’t as effective.

And I would not bother with over-the-counter strength paracetamol and codeine (co-codamol) as it doesn’t contain enough codeine to add much other than side effects like constipation (stronger prescription-only versions are much better pain-relievers).

However, the best remedy for the short-term pain of things like a headache or a twinge in your back is probably a combination of ibuprofen and paracetamol.

At least that is what scored highest in a review by a team of researchers from the University of Oxford. They found the optimum mix to be 200mg ibuprofen and 500mg paracetamol taken at the same time, preferably on an empty stomach.

I know the instructions on ibuprofen normally say to take with or after meals, however there is little evidence that this does much to protect the stomach, but does slow absorption, reducing efficacy.

And wash the combination down with a cup of strong coffee, as caffeine can boost the pain-relieving effect.